中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2015年
5期
358-361
,共4页
颅内动脉瘤%破裂%危险因素
顱內動脈瘤%破裂%危險因素
로내동맥류%파렬%위험인소
Intracranial aneurysm%Rupture%Risk factors
目的 探讨颅内动脉瘤破裂出血的危险因素,为临床防治措施的制定提供理论依据.方法 回顾性分析2010年1月到2013年12月我院收治的脑动脉瘤患者278例的临床资料,其中发生颅内动脉瘤破裂患者122例(破裂组),未发生颅内动脉瘤破裂患者156例(未破裂组).收集两组患者的各项临床资料,通过单因素分析和多因素logistic回归分析探讨颅内动脉瘤破裂出血的危险因素.结果 破裂组女性、有嗜烟史、有高血压病史、颅内动脉粥样硬化的比例显著高于未破裂组[70.5％ (86/122)与59.0％ (92/156),42.6％(52/122)与29.5％ (46/156),63.9％(78/122)与51.9％(81/156),69.7％(85/122)与51.3％ (80/156),x2值分别为3.943、5.175、4.034和4.319,均P＜0.05];破裂组患者动脉瘤颈宽度(5.1±2.3)mm、动脉瘤体直径(4.8±2.1)mm,均显著低于未破裂组[(8.5±5.5)和(8.4±6.7)mm,t值为5.642和6.383,均P＜0.01];瘤体直径＜5、5～8、＞8 mm者的动脉瘤破裂率[63.4％ (64/101)、40.9％(38/93)、25.0％ (21/84)]依次显著降低(Z=27.180,P=0.000);瘤颈宽度＜4 mm的颅内动脉瘤破裂率为67.3％(66/98),显著高于瘤颈宽度≥4 mm的颅内动脉瘤[31.1％(56/180),x2=33.832,P=0.000];多因素logistic回归分析显示,动脉瘤体直径是颅内动脉瘤破裂的独立危险因素(OR=3.759,95％CI:1.638～6.897,P=0.000).结论 瘤体直径为颅内动脉瘤破裂出血的独立危险因素,临床上应综合患者的病史、影像学检查等各项资料制定相应的诊疗方案,降低颅内动脉瘤破裂出血的风险.
目的 探討顱內動脈瘤破裂齣血的危險因素,為臨床防治措施的製定提供理論依據.方法 迴顧性分析2010年1月到2013年12月我院收治的腦動脈瘤患者278例的臨床資料,其中髮生顱內動脈瘤破裂患者122例(破裂組),未髮生顱內動脈瘤破裂患者156例(未破裂組).收集兩組患者的各項臨床資料,通過單因素分析和多因素logistic迴歸分析探討顱內動脈瘤破裂齣血的危險因素.結果 破裂組女性、有嗜煙史、有高血壓病史、顱內動脈粥樣硬化的比例顯著高于未破裂組[70.5％ (86/122)與59.0％ (92/156),42.6％(52/122)與29.5％ (46/156),63.9％(78/122)與51.9％(81/156),69.7％(85/122)與51.3％ (80/156),x2值分彆為3.943、5.175、4.034和4.319,均P＜0.05];破裂組患者動脈瘤頸寬度(5.1±2.3)mm、動脈瘤體直徑(4.8±2.1)mm,均顯著低于未破裂組[(8.5±5.5)和(8.4±6.7)mm,t值為5.642和6.383,均P＜0.01];瘤體直徑＜5、5～8、＞8 mm者的動脈瘤破裂率[63.4％ (64/101)、40.9％(38/93)、25.0％ (21/84)]依次顯著降低(Z=27.180,P=0.000);瘤頸寬度＜4 mm的顱內動脈瘤破裂率為67.3％(66/98),顯著高于瘤頸寬度≥4 mm的顱內動脈瘤[31.1％(56/180),x2=33.832,P=0.000];多因素logistic迴歸分析顯示,動脈瘤體直徑是顱內動脈瘤破裂的獨立危險因素(OR=3.759,95％CI:1.638～6.897,P=0.000).結論 瘤體直徑為顱內動脈瘤破裂齣血的獨立危險因素,臨床上應綜閤患者的病史、影像學檢查等各項資料製定相應的診療方案,降低顱內動脈瘤破裂齣血的風險.
목적 탐토로내동맥류파렬출혈적위험인소,위림상방치조시적제정제공이론의거.방법 회고성분석2010년1월도2013년12월아원수치적뇌동맥류환자278례적림상자료,기중발생로내동맥류파렬환자122례(파렬조),미발생로내동맥류파렬환자156례(미파렬조).수집량조환자적각항림상자료,통과단인소분석화다인소logistic회귀분석탐토로내동맥류파렬출혈적위험인소.결과 파렬조녀성、유기연사、유고혈압병사、로내동맥죽양경화적비례현저고우미파렬조[70.5％ (86/122)여59.0％ (92/156),42.6％(52/122)여29.5％ (46/156),63.9％(78/122)여51.9％(81/156),69.7％(85/122)여51.3％ (80/156),x2치분별위3.943、5.175、4.034화4.319,균P＜0.05];파렬조환자동맥류경관도(5.1±2.3)mm、동맥류체직경(4.8±2.1)mm,균현저저우미파렬조[(8.5±5.5)화(8.4±6.7)mm,t치위5.642화6.383,균P＜0.01];류체직경＜5、5～8、＞8 mm자적동맥류파렬솔[63.4％ (64/101)、40.9％(38/93)、25.0％ (21/84)]의차현저강저(Z=27.180,P=0.000);류경관도＜4 mm적로내동맥류파렬솔위67.3％(66/98),현저고우류경관도≥4 mm적로내동맥류[31.1％(56/180),x2=33.832,P=0.000];다인소logistic회귀분석현시,동맥류체직경시로내동맥류파렬적독립위험인소(OR=3.759,95％CI:1.638～6.897,P=0.000).결론 류체직경위로내동맥류파렬출혈적독립위험인소,림상상응종합환자적병사、영상학검사등각항자료제정상응적진료방안,강저로내동맥류파렬출혈적풍험.
Objective To investigate the risk factors of rupture of intracranial aneurysms.Methods Two hundred and seventy eight patients with cerebral aneurysms admitted from January 2000 to December 2013 were enrolled in study,including 122 cases with ruptured intracranial aneurysm (rupture group) and 156 cases without rupture (non-rupture group).The clinical data were collected from two groups,risk factors of aneurysm rupture were studied by univariate analysis and multivariate logistic regression analysis.Results The rates of female gender,smoking history,hypertension and atherosclerosis in rupture group were significantly higher than those in non-rupture group [70.5％ (86/122) vs.59.0％ (92/156),42.6％ (52/122) vs.29.5％ (46/156),63.9％ (78/122) vs.51.9％ (81/156) and 69.7％ (85/122) vs.51.3％ (80/156);x2 =3.943,5.175,4.034 and 4.319,respectively,all P ＜ 0.05];the width of aneurysm neck and diameter of aneurysm in rupture group were significantly lower than those in non-rupture group (all P ＜ 0.05).In addition,the rates of aneurysm rupture in patients with aneurysm diameter of ＜ 5 mm,5-8 mm and ＞8 mm were 63.4％ (64/101),40.9％ (38/93),25.0％ (20/84),respectively,Z =27.180,P =0.000;the rates of aneurysm rupture in patients with aneurysm neck width of ＜4 mm was higher than that with width ≥ 4 mm [67.3％ (66/98) vs.31.1％ (56/180),x2 =33.832,P =0.000].Multivariate logistic regression analysis showed that aneurysm diameter is an independent risk factor for rupture of intracranial aneurysm (OR =3.759,95CI:1.638-6.879,P =0.001).Conclusions The diameter of intracranial aneurysm in an independent risk factor for aneurysm rupture.Female gender,history of smoking,underlying hypertension and atherosclerosis,and the width of aneurysm neck may also related to the rupture of intracranial aneurysms.
